Method for removing an orthopedic cast utilizing an embedded wire

ABSTRACT

Method and apparatus are disclosed for removing an orthopedic cast by cutting action of wire embedded in the cast, including the method for embedding the wire and for removing the cast with rachet apparatus secured to the wire.

l 0 United States Patent [11] 3,867,931

Babka Feb. 25, 1975 [54] METHOD FOR REMOVING AN 2,746,452 I 5/1956 Saylors 128/91 A gg ggggig s i i UTILIZING AN FOREIGN PATENTS OR APPLICATIONS 888,595 9/1953 Germany 128/91 A [76] Inventor: Joseph A. Babka, 414 E. Roeser, 702,121 1/1954 Great Britain 128/91 A Apt. 175, Phoenix, Ariz. 85040 22 Filed; 19 1973 Primary ExaminerRichard A. Gaudet Assistant Examiner-l Yasko [21] Appl. No.: 426,305

57 ABSTRACT [52] U.S. Cl 128/91 A 1 51 Int. Cl. A611 5/04 Method and apparatus are dlsclosed for removmg 58 Field of Search 128/91 A, 91 R, 90, 83 Orthopedic cast y cutting action of wire embedded in the cast, including the method for embedding the wire 5 References Cited and for removing the cast with rachet apparatus se- UNITED sTATEs PATENTS cured 2,342,695 2/1944 Rinaldy 128/91 A 4 Claims, 13 Drawing Figures PAIENTEU FEB 2 5 m7;

SHEET 3 OF 4 FIGM-H METHOD FOR REMOVING AN ORTHOPEDIC CAST UTILIZING AN EMBEDDED WIRE BACKGROUND OF THE INVENTION 1. Field of the Invention:

This invention relates to orthopedic casts, and, more particularly, to the removal of orthopedic casts utilizing rachet apparatus and wire embedded in the cast to cut thecast material, including the method for embedding the wire and for using the embedded wire to cut the cast for removal.

2. Description of the Prior Art In the field of orthopedic medicine, particularly that portion of orthopedic medicine dealing with the immobilization of a limb or of a portion of a body, the application and removal of casts comprises an important and a time consuming field of endeavor. Casts are typically formed about a limb or about the body for the purpose of immobilizing a joint above a specific location and a joint below the specific location. The purpose of immobilizing the joint above and below the specific location is of course to insure that the specific location, which is most typically the location of a break or fracture, is completely immobilized. Only by immobilizing the appropriate joints can complete immobilization of a specific fracture location be accomplished. Accordingly, a cast will typically include an angular portion, in addition to a straightportion. Seldom does a cast include only a straight portion.

While a number of new casting procedures and materials have been suggested, such as fiberglass and epoxy casts, plaster of paris is still by a wide margin, the most universally used material for casting. Typically, the

casting of a limb begins with the placing of a cotton mesh sleeve, tubular in configuration, over the limb to be cast. Over this cotton mesh sleevethere is generally placed a layer of cotton webbing. Plaster bandage, which is a mesh impregnated with plaster, is then rolled circumferentially about the limb and about the cotton mesh and webbing layers. The plaster mesh is layered over the limb in accordance with the severity of the break and in accordance with the potentiality for movement of the limb. For example, if an axial crack in the ulna of the forearm is discovered, a light to medium cast of four to six layers may be required, whereas if the break in the ulna were a compound fracture, a heavier cast of six to eight layers may be required. Similarly, if a walking cast is desired for a leg or ankle, the potential stress and strain on the cast would require many more layers of plaster than if the patient-we're confined to a bed or did not intend to walk on the cast.

However, regardless of the thickness of the castydefined in terms of layers of plaster mesh, there is still a universal problem of removing the cast at the appropriate time. The older the cast, the more brittle the plaster of paris becomes. Regardless of the age of the cast, with prior art tools, the removal of the cast is time consuming, dirty, in the sense that a substantial amount of dust is generated, and is often extremely uncomfortable to the patient and is potentially dangerous.

Prior art devices used to remove casts are generally electrically operated, using an electric motor, to power a vibrating cutting tool or cutting edge. A direct consequence of the vibration is discomfort to the patient and a very substantial amount of plaster of paris residue in the form of dust. There is also a likelihood or at least 2 a very definite possibility of injury to the skin of the patient. Such injury may occur if the cutting tool goes through a soft spot in the cast or if the cutting tool simply gets away from the user thereof.

Another deficiency with prior art devices is the amount of time which is required to cut through the plaster of paris layers which make up a cast. During this length of time, which is typically not less than ten or fifteen minutes for the smallest cast, the patient is subject to the discomfort of the cutting apparatus, with its vibration and other problems, as discussed above.

SUMMARY OF THE INVENTION of the loop in the wire exterior or outside of the cast at an appropriate location, such as at a bend or curve of the cast, and the removal of the cast by applying a rachet tool to pull the wire through the cast to break the cast.

Among the objects of the present invention are the following: I

To provide new and useful method for removing a cast; I

To provide a new and useful method for removing a cast utilizing a wire embedded in the cast; I

To provide a new and useful method for embedding a wire in a cast and for removing the wire from the cast;

BRIEF DESCRIPTION OF THE DRAWING FIG. 1 is a view in partial section of a cast on the limb of a person which cast utilizes the present invention.

FIG. 2 is an enlarged view ofa portion of the apparatus of FIG. 1.

FIG. 3 is an enlarged view of another portion of the apparatus of FIG. 1.

FIG. 4-is a view disclosing apparatus of the present invention in use.

FIG. 5 is a view of a portion of the apparatus of FIG. 4 taken along the line 55.

FIG. 6 is a view of a portion of the apparatus of FIG. 5 taken along Line 6-6.

FIG. 7 is a view of an alternate embodiment of apparatus of the present invention.

FIG. 8 is a view of another embodimentof apparatus of the present invention.

FIG. 9 is a view of the apparatus of FIG. 8 taken along Line 9-9.

FIG, 10 is a view illustrating an alternate method of embedding wire.

FIG. 11 is a view of a wire anchor. FIG. 12 is a view illustrating the use of a wire anchor. FIG. 13 is a view of a spool and a pair of rollers.

DESCRIPTION OF THE PREFERRED EMBODIMENT FIG. 1 shows a view of a portion of the lower part of a torso with a leg extending therefrom. The leg includes a thigh portion 10, and a portion of a foot I2. Between the foot and the thigh is a cast 20. In common orthopedic practice, a cast is used to immobilize a limb or other member of the body to allow the: bodily healing processes to occur. Perhaps the most common example of I such situation is with a broken arm. or, as shown in FIG.

1, and in FIGS. 2, 3, and 4, a broken leg or portion of a leg.

When a cast is placed on some portion of the human anatomy, it is of course obvious that such cast must be removed. Typically, there are two types of casts utilized today, the plaster of paris type cast which is the most used, and epoxy casts, which are increasing in popularity. The plaster of paris casts are placed on a limb in the form of plaster bandages and the plaster of paris hardens and thus immobilizes the limb. The The epoxy casts are thinner and lighter in weight than plaster casts. Prior to use, an epoxy resin is mixed with a hardening or curing agent which causes the resin to cure in a period of time to immobilize the limb or body portlon.

Referring again to FIG. 1, a wire 22 is embedded in the cast on the anterior or front portion of the leg, and the wire includes a loop 24 which extends out from the cast. The use of the loop will be discussed in detail below.

The wire 22 is embedded in the cast and secured at the ends of the cast. The wire is used to split or break open the cast thus allowing for the cast to be removed. The wire is embedded in the cast underneath the plaster bandage layers such that the upward pulling on the wire results in the wire breaking through the hardened layers of plaster bandage. The loop 24 extends outwardly from the layers of plaster and is accordingly used as a beginning point for the removal of the wire through the layers of plaster. In other words, the wire loop may be split and the respective portions of the wire wound about a suitable tool and moved in both directions, towards the thigh 10 in one direction, and in the opposite direction toward the foot 12, to break the cast in both directions from the middle area or portion outwardly.

FIG. 2 is an enlarged view of the circled portion 2 FIG. 1. The thigh of the individual is shown with the cast and the embedded wire disposed about the thigh.

A typical cast application will include a cotton sleeve 28 disposed about the limb adjacent the skin. The ends of the sleeve are usually folded back and inverted withinthe layers of plaster bandage to hold the sleeve in place and to provide a smooth contour at the ends of the cast. A layer of cotton webbing is disposed about the sleeve as a cushion for the limb and as a barrier to prevent the chafing of the plaster bandage on the limb.

The length of wire 22 is then placed on the limb, as shown in FIG. 2 and in FIG. 1 on the anterior side of the limb. If desired, a wire could similarly be embedded in the posterior side or portion of the limb to provide for a double split of the cast. The wire 22 includes a reverse portion 26 which is bent back or reversed to securely embed the wire within the layers of plaster.

After the wire has been placed on the limb, the plaster bandage is then wound about the limb. A plurality of layers 32 of plaster are shown wound about the limb l0. Preferrably 5 or 6 layers of plaster bandage are used in a typical cast. If required, there may be more layers, as necessary, to immobilized the broken or affected limb. As illustrated in FIG. 2, the reverse portion 26 of the wire 22 is disposed on top of the second or third layer of plaster bandage, and the reverse portion 29 of the sleeve 28 is disposed also adjacent the wire and on top of the second or third layer of plastic bandage. Thereafter, about three more layers of plastic bandage 32 are wound about the limb to complete the cast. When the plaster cast becomes hardened, the wire will be securely held to the bonded layers ofplaster and will remain there until the cast is removed. Obviously, the wire causes no discomfort or other effect to either the limb or the wearer of the cast or to the cast itself.

It has been found that stainless steel wire, of a spring temper, is preferrable for cast removal. This stainless steel wire is generally a chromium-nickel alloy. Three gauges of wire have been used, depending on the thick ness or weight of the cast. The gauges are 17 V2, 23, and 25. Their respective diameters are 0.040 inches, 0.051 inches, and 0.059 inches. It has been found that the 23 gauge wire, with a diameter of 0.051 inches is generally heavy enough for most types of casts.

FIG. 3 is an enlarged view of the circle 3 of FIG. 1, and it shows the loop 24 of the wire 22. The cast 14 in FIG. 3 is over the knee cap or patella and the loop 24 extends out of the cast at about the bend of the knee.

As shown in FIGS. 1, 2, and 3, the cast illustrated herein is typical of a hanging cast used for an injury to the patella. A cast for an injured leg normally extends over the ankle onto the foot so as to immobilize the foot (or the limb) below the affected area. That is, a cast usually immobilizes the joints above and below the injured portion.

To remove the cast shown in FIGS. 1, 2, and 3, the wire 22 is cut in about the middle of the loop 24. With the loop cut, a special tool, as described in detail below, is secured to one of the free ends of the wire 22 and a force applied to roll the wire onto the tool and as the wire is rolled up, the wire breaks through the layers of plaster, thus splitting the cast. When one portion of the cast has thus been split, the tool is removed and is applied to the other free end of the wire 22 and similarly moved or rolled in the opposite direction to split the other portion of the cast. As indicated above, another wire may be used in the opposite portion of the limb to split the cast in two places.

FIG. 4 is a continuation of FIGS. 1, 2, and 3, illustrating the cutting or fracturing of the cast 20 using a tool 40. The loop 24 of FIGS. 1 and 3 has been cut in FIG. 4 and the wire 22 is thus in two pieces, an upper piece 22a, which is shown wound about the tool 40, and a piece 22b, which is the lower portion of the wire. In FIG. 4 the tool 40 is illustrated as fracturing or cutting the cast 20 from the area of the knee l4 upwardly on the limb 10. j

The tool 40 includes a handle 42 and a rachet portion 43. The handle and the rachet portion are secured to spool 44, to which is secured the upper portion of wire 22a. The movement of handle 42 in a back and forth aarcuate motion, with rachet action through rachet apparatus 43, will result in movement of the spool 44 along the upper portion of the cast 20. Since the wire 22a is wound about the spool, movement of the rachet and the rotary motion of the spool imparted by the tool will cause the wire to be drawn upwardly through the cast. This in turn will result in the cutting or fracturing of the cast. Accordingly, as the wire is being wound about the spool 44, the cast will be sufficient'to allow the cast to be removed from the limb to which it is applied. With the opposite end of the wire 22, that is, opposite that which is wound about the spool 44, secured within the cast at the extremity thereof, the wire will remain in place and will not pull out of the cast when tension is applied to the wire by the tool 40.

As shown in FIG. 4, the cast 20 has been fractured upwardly from where the loop 24 (see FIGS. 1 and 3) extended from the cast. When the tool 40 has been used to fracture the upper portion of the cast to the upper extremity of the cast, the wire 22a will be removed from the spool 44 and wire 22b will be secured thereto. The tool 40 will then be used to wind the wire about the spool to fracture the lower portion of the cast. Upon completion of the fracturing or splitting of the cast along its entire length, either hand pressure or a cast splitter may be used, as is well known in the art, to fracture the lower or posterior portion of the cast to allow the limb to be totally and completely freed from the cast. As previously indicated, if desired, another wire may be placed along the limb in the posterior portion of the cast substantially opposite wire 22 and the same procedure as described herein may be used with such other wire to completely split the cast into two portions to thus remove the cast without requiring a cast splitter or other physical exertion to split the cast.

The use of the tool to split the cast using the embedded wire is accomplished with substantial speed, without undue discomfort to the wearer or the cast, without dust and debris which accompanies the use of prior art cast cutters, and without the inherent problem of possible cuts and/or contusions to the wearer of the cast, all of which accompany prior art cast cutting apparatus.

FIG. 5 is a view in partial section of a portion of the apparatus of FIG. 4 taken substantially along line 5-5 of FIG. 4. The apparatus shown in FIG. 5 is the tool 40 from FIG. 4. The tool 40 includes a handle 42 secured to rachet apparatus 43 which is in turn secured to spool 44 by a shaft 66. Shaft 66 is preferably an integral part of the spool 44. Oscillating movement of handle 42 through rachet apparatus 43 imparts rotary motion to spool 44' and to wire secured thereto. Spool 44 includes a reduced diameter central portion 46. Adjacent the reduced diameter central portion 46 is a pair of sloping or trapering portions 48 and 50 which are substantially identical in configuration. From the reduced diameter portion 46, the sloping portions extend outwardly and thus increase in diameter until they terminate respectively in a pair of shoulders 53 and 55 which are in turn adjacent full diameter roller portions 52 and 54. As I]- lustrated in FIG. 4, the full diameter roller portions 52 and 54 act as wheels or runners by bearing againsta cast on either side of wire to which theapparatus or tool 40 is secured for removal. If desired, the roller portions may be knurled for increased friction along the cast. In the alternative, and again if desired, radially extendingconical studs may be disposed on the exterior periphery of the roller portions to insure or increase frictional contact with any type cast, plaster or epoxy.

A central aperture or bore 60 extends through the spool 44 at the reduced diameter central portion 46. At

substantially a right angle to and intersecting the aperture or bore 60 is a radially extending bore 62, which is tapped to receive a set screw 64. The central bore 60 extends diametrally through the spool 44 and it receives an end of a wire, such as wire 22a of FIG. 4. With the wire extending at least half way through the bore 60, and further if desired, set screw 64 in the tapped bore 62 which extends only to the bore 60, is tightened against the wire to lock the wire in place within the bore 60. With the set screw locking the wire to the spool, the apparatus is ready for use to pull the wire. through a cast to cut or fracture the cast.

A pair of shafts 66 and 68-extend coaxially with respect to each other outwardly from and along the axis of the spool 44. A knob 70 is secured to the shaft 68 and spool 44. At the opposite end of spool 44 is the shaft 66, to which is secured the handle 42 and rachet apparatus 43.

In use, a wire extends through bore 60 and is locked in the bore by a set screw 64 disposed in the tapped bore 62. With oscillating or back and forth movement imparted to handle 42, which is secured to rachet apparatus 43, the oscillating movement of the handle is transformed through the rachet apparatus 43 and shaft 66 to rotary motion of the spool windsthe wire about the spool on the reduced diameter central portion 46 and the adjacent sloping portions 48 and S0. The full diameter roller portions 52 and 54 of the spool 44 allow the spool to be moved over the cast bearing surfaces on the cast. The shaft 68'and knob 70 allow the tool to be guided and held onto the cast by the user of the tool or apparatus 40.,

FIG. 6 is a view of the apparatus of FIG. 5 taken along line 6 6 of FIG. 5. It is a view generally along the axis of spool 44. The bore 60 and the bore 62 with its set screw 64 are all shown in phantom. The full diameter roller portion 54 of the spool 44 and the shaft 66 are illustrated. The lessor diameter portions 46 and 55 are illustrated in phantom. The reduced diameter central portion 46 through which bore 60extends, is, of course, the smallest diameter portion of the apparatus. The shoulder 55 is illustrated in phantom at the juncture of the sloping portion 50 (see FIG. 5). If desired, the bore 60 need not extend through the entire spool, but need extend only far enough so that set screw 64 may be secured against the wire to lock it against the bore 60.

An alternate embodiment of tool apparatus for wire removal is illustrated in FIG. 7. In FIG. 7, tool apparatus includes a spool 82which is substantiallythe same as the spool 44 of FIGS. 4, 5,. and 6. The spool 82 includes a pair of full diameter roller portions84 and 86, which comprise circular wheels or runners which together provide a bearing surface upon which the tool moves on or over a cast. Adjacent the roller portions 84 and 86 are respectively shoulder portions and 87. Inwardly from the shoulder portions are a pair of sloping portions 88 and 90. The sloping portions 88 and 90 extend and taper from the respective shoulders 85 and 87 inwardly to a reduced diameter central portion 92 is the areaor portion with the least or smallest diameter of the apparatus. At the central portion 92 is a center bore 94 which extends diametrically into, and, if desired, through, the spool 82. The bore 94receives an end of wire prior to the cast cutting operation. The wire is secured to thespool by a set screw 96 which is received in a tapped bore or hole also extending into the spool radially thereof and intersecting the bore 94. V

A yoke 100 is secured to the spool 82 to impart rotary motion to the spool and thus to wind wire about the spool to fracture a cast. The yoke includes a pair of arms 102 and 104 which are secured to the spool at opposite ends thereof, adjacent respectively the full diameter roller portions 84 and 86. A center or connecting bridge portion 106 extends between the arms 102 and 104, at substantially right angles thereto. A handle 108 extends from the connecting bridge portion 106 outwardly therefrom, generally parallel to the arms 102 and 104. Disposed about the handle 108, and telescoping therewith, is an outer handle or handle grip 110. The grip is shown preferably knurled or in some manner texturized for better gripping by a user. The outer handle or grip 110 is telescopingly movable on the handle 108, and is secured thereto by a threaded thumbscrew 112. If a longer lever arm is desired, the outer handle or grip 110 may be moved or positioned as desired with respect to the handle 108 and secured thereto at any of several positions by securing the thumbscrew 112 in an appropriate tapped hole 114. There are a plurality of tapped holes 114 in the handle 108.

The yoke 100, with its handle 108, is secured to the spool 82 through rachet apparatus 116 on one end of the spool 82. As in the embodiments of FIGS. 4 and 5, the rachet apparatus is well known in the art, and allows oscillating movement to be translated into a rotary movement in one direction. By reversing the rachet apparatus, the rotary movement in an opposite direction may be attained by the same oscillating movement. At the end of spool 82 opposite from rachet apparatus 116, the yoke 100, through arm 104, may be rotably secured to the spool. Thus, the yoke and handle are secured to the spool at one end by rachet apparatus and the opposite end are simply secured for free rotation.

In use, the tool apparatus may be operated with one hand, gripping the outer handle 110. With the outer handle 110 telescopingly movable on the handle 108, an increased radius arm or force arm may be used as desired to increase the leverage and accordingly the torque applied to the spool.

Still another embodiment of the wire removal apparatus is shown in FIGS. 8 and 9. Wire removal tool apparatus 120 in FIG. 8 includes a spool 122 having a pair of full diameter roller portions 124 and 126, each of which include respectively a shoulder portion 125 and 127. A reduced diameter portion 132 is centrally disposed between the roller portions 124 and 126. A pair of sloping portions 128 and 130 extend outwardly from the reduced diameter central portion 132 and the respective shoulders 125 and 127. As in previous embodiments, the sloping portions vary in diameter from a maximum diameter adjacent the shoulders to a minimum diameter at the reduced diameter central portion. In operation, the wire is wound about the spool in the area of the reduced diameter central portion and the adjacent sloping portions to allow the full diameter roller portions to contact and bear against a east throughout the cast removal process.

A central bore 134 extends diametrally through the spool 122 at the reduced diameter central portion 132.

The bore 134 receives the wire which is locked in place therein, as further illustrated in FIG. 9 and discussed below.

A generally U-shaped yoke 140 is secured to the spool adjacent the roller portions 122 and 126. The U- shaped yoke 140 includes a pair of arms 142 and 144 which extend to and are secured to the spool outwardly from the roller portions 124 and 126, respectively. Tubular members 146 and 148 are telescopingly disposed about the arms 142 and 144, respectively. A cross piece 150 extends between the tubular members 146 and 148 and is secured thereto. A handle or grip is disposed about the cross piece 150. A pair of locking members 154 and 156 are respectively disposed about the tubular members 146 and 148 to lock the tubular members with the cross piece and handle to the arms 142 and 144. The tubular members, with the arms, are movably extensible to increase or decrease the radius arm and accordingly the force on the spool, as desired.

The yoke 140 is secured to the spool 122 by rachet apparatus 160 on one end of the spool 122 and by bearing apparatus 162 at the opposite end of the spool. The bearing apparatus 126 is freely movable with respect to the spool 122. The arm 142 is connected to the rachet apparatus 160 adjacent the full diameter roller portion 124, and the arm 144 is connected to the bearing apparatus 162 adjacent the full diameter roller portion 126.

FIG. 9 is a view of the apparatus of FIG. 8 taken generally along line 9-9 of FIG. 8, and the apparatus is shown in partial section. Portions of the spool 122 and the yoke apparatus 140 are shown in partial section to further illustrate the embodiment. Spool 122 is shown, with its full diameter roller portions 124 and 122 disposed outwardly from sloping portions 128 and 130. The sloping portions extend from a reduced diameter central portion l32outwardly to terminate in shoulders and 127 adjacent the rollers 124 and 126, respectively. The bore 132 extends diametrally through the spool at the reduced diameter central portion 132. A threaded axially extending bore 136 extends through the spool 122 substantially at a right angle to the bore 134. The bore is internally threaded to receive a locking member 138. The locking member 138 also extends through the bearing portion 162 to which the arm 144 of the yoke is secured. The locking member 138 comprises a set screw or elongated thumbscrew with a generally flat outwardly extending head portion for ease for use. When a wire is inserted into the bore 134, the locking member or set screw 138 is screwed in the bore 136 against the wire to hold the wire in place. If desired, the set screw apparatus of the embodiments of FIGS. 5 and 7 may be used herein. Also, obviously, the set screw locking apparatus of FIG. 9 may be used in the other embodiments, as desired.

Tubular members 146 and 148 are disposed respectively about the arms 142 and 144 and are telescopingly movable thereon. Thus, if it is desired to lengthen or to shorten the lever arm of the apparatus, the locking members 154 and 156 may be unscrewed from threaded engagement with their respective arms in order to allow free movement of the tubular members about the arms. When the tubular members, with the cross piece 150, are in the desired position the locking members are tightened to secure the arms and the tubular members together. The handle or grip 152, as illustrated in FIG. 9, may be supported on the cross piece by appropriate bearings, as desired. Such an arrangement would materially reduce the friction between the trip or handle 152 and the cross piece 150 to allow free relative movement thereof as the yoke is oscillated by the user to wind a wire upon the spool.

ln FIGS. 1, 2, 3, and 4, the wire is illustrated as having a loop in the center portion or the cast, or about mid-way between the upper and lower extremities of the cast, with the end(s) embedded within the cast to anchor the wire. As an alternate, if a loop is not desired, one end of the wire may be secured to the cast as shown in FIG. 2. The other end, or the free end, to which the tool or spool apparatus will be secured, may be taped to the cast, using a small hook or return loop at the free end. The small hook or return loop is advantageous toprevent scratching, chafing, etc. The use of such returned portion of the wire is illustrated in FIGS. l0, l1, and 12, with an anchor block used to hold one end of the wire when ratchet tool apparatus is employed at the other end of the wire to fracture the cast.

FIG. illustrates the use of an implanted wire when a loop is not desired, or when it is simply more convenient or desirable to allow both ends of an implanted wire to be disposed externally ofthe cast, instead of anchoring one end within the cast, as shown in FIG. 2. The type of cast illustrated in FIGS. 10 and 12 is a typical cast for a broken arm, such as for a fracture of the ulna or radius, the bones in the forearm. A cast 170 extends about an arm 16 from adjacent the shoulder joint to a hand 18, including the wrist. As previously indicated, it is typical in the application of casts to immobolize joints both above and below the fracture area. Accordingly, if the fracture is in a bone in the forearm, both the elbow and the wrist would be immobolized. Thus the cast in FIG. 10 is typical for such a break. A similar cast may be employed if the humerus in the upper arm is fractured. A wire has been embedded in cast 170 with an upper end 221 adjacent the arm and a lower end 222 adjacent the hand not embedded or anchored within the cast, but simply bent so as to form a hook or return portion of the wire disposed against the exterior of the cast.

A piece of tape 172 is placed over the end 221 of the wire to hold the wire in place against the cast. Similarly, a piece of tape 174 is placed over the wire end 222 to hold the end against the cast. With both ends 221 and 222 available outside the cast, the cast may be removed from either end, as desired.

To remove such cast, using either free end, an anchor must be employed to hold one end of the wire while a ratchet .tool, such as illustrated and discussed previously, and as shown in FIG. 12, is used to fracture the cast using the other free end of the wire. Such an anchor is shown in FIG. 11. FIG. 11 discloses the use of an anchor 180 which is employed exteriorally of the cast to hold one end of the wire to prevent the wire from being pulled through the cast as the other end of the wire is rolled about the spool of a tool to fracture the cast. The anchor 180 is a cylindrical block, preferably with rounded ends to prevent scratching, chafing, or the like, and with an aperture or hole 182 extending diametrically through the block. The end 222 of the wire extends through the aperture or hole 182 and is simply wound about the anchor block 180 to securely hold wire to the block.

FIG. 12 illustrates the use of the anchor block 180 with a .tool 20, such as illustrated in FIGS. 5 and 6, to fracture the cast 170. Wire 220, shown in phantom in FIG. 12, is embedded within the cast 170 according to the typical procedures discussed above. The end 222 of the wire 220 is shown wrapped about the anchor block 180, and the anchor block is disposed agains the end of the cast by the hand 18. The anchor block 180 bears against the end of the cast 170 adjacent hand 18 as tension is applied to the wire 220 by tool 40. The upper end 221 of the wire is secured to the tool 40 and is used to fracture the cast from the upper arm downwardly to the hand. With the anchor block disposed against the end of the cast, the tension applied to the block by the wire 220 is opposed by the end of the cast against which the block bears and is thus transmitted to a substantially large portion of the cast. The anchor block thus serves to prevent the wire from being pulled through the cast.

The method and apparatus for the removal of casts from an immobilized portion of the body disclosed herein is efficient and free from the disadvantages of prior art cast cutting apparatus. It is obvious that the apparatus disclosed herein may be used by a single individual, either male or female, without regard to theindividual strength or physical capabilities of the user. Moreover, the apparatus may be used virtually anywhere, without regard to the limitations of an electrical cast cutter, as for example in surgery where the possi' bility of a spark prohibits the use of an electrical cast cutter. Both the implanting or imbedding of a length of wire within a cast and the presence of the wire during the period which the cast is in place, are free from problems by or from either the individual putting on the cast or the individual on whom the cast is put. As indicated in the drawings, the handles may be knurled for better gripping action by an operator, and the rollers may also be knurled or studded for increased friction on the cast. In the implantation of the wire, the stocking over the anchor, or return portion of the wire, is generally slit to prevent interference with the wire as the wire is used to cut the cast. After a period of drying and cooling of the cast, the free end is preferably bent against the cast and taped. Similarly, the loop, if such is used, asshown in FIGS. 1, 3, and 4, is simply bent against the cast and taped by winding tape circumferentially around the cast. The day following the application of the cast, and after the casthas completely, or substantially completely, dried, the original tape used for either the free end or the loop may be replaced by a smaller piece of tape on the dry cast. Such smaller piece of tape overlying only the wire would not have held on the original wet cast had it been used thereon.

Thus, it is necessary originally to tape the free end or the loop to the cast by winding tape around the cast over the wire. If desired, the winding maybe replaced by a smaller patch of tape.

If a cast needs to be opened to relieve pressure at the site of the injury, the wire may be: used to open a few inches of the cast. Accordingly, the free end of the wire, or a loop, should preferably be adjacent the injury. After the pressure has been relieved, the cast may be repaired by using more plaster bandage. By use of the wire and wire removal apparatus disclosed herein, such accommodations to the cast may be made without injury or discomfort to the wearer of the cast.

It may be desirable to remove a strip of cast material rather than merely fracture the cast by a single crack or opening. To accomplish the removal of a strip from.

a cast, apparatus including a spool 300 shown in FIG. 13 may be employed. I

Spool 300 includes a pair of rollers 302 and 303, each of which includes a plurality of studs 304 on the periphery of the rollers to increase the friction between the spool rollers and a cast with which the apparatus is employed. Rather than having a pair of sloping surfaces extending to a central reduced diameter portion, as in the embodiments of the spools of FIGS; 4-l0 and 12, spool 300 includes a central portion 306 of substantially constant diameter between the rollers 302 and 303. It may be noted that, if desired, the spool embodiments previously mentioned may also use central portions of constant diameter rather than reduced diameter and sloping portions shown.

In the central portion 306 are three spaced apertures 308, 309, and 310 extending diametrally through the spool. The apertures 308 and 310 are substantially parallel to each other and are spaced apart about 2 inches, or the width of the strip of cast material to be removed. The spool also includes tapped holes 312, 313, and 314 extending to and intersecting the respective apertures 308, 309, and 310. The tapped holes receive set screws which lock in place wires extending into and/or through the apertures.

The aperture 309 with its intersecting tapped hole is centrally disposed in the center portion between the rollers 302 and 303. If only a single wire is desired, the aperture 309 may be used to remove the wire.

When double wires are used with a cast they are spaced apart about the width between the apertures 308 and 310. When the cast is ready for removal, the pair of wires would be inserted through apertures 308 and 310 respectively, and appropriate set screws in tapped holes 312 and 314 would be secured to hold the wires in the apertures. The spool will then be used as described above to wind the wires onto the spool. With the pair of wires utilized to fracture the cast, the strip of cast material between the wires may then be removed, leaving a gap in the cast from which the mate rial was removed.

With also the center aperture 309, the same spool may be used to remove a single wire, as described above in conjunction with the other embodiments. Thus the embodiment of FIG. 13 may be used to remove either a single wire or a pair of wires, as desired.

The ratchet apparatus has been omitted from the embodiment of FIG. 13, but obviously any ratchet, with any yoke or handle may be employed.

Under some circumstances it may not be desirable to implant a wire within a cast, but a nylon or other cord may be implanted. Such cord can be used to draw a wire through the cast at a later time.

While the principles of the invention have been made clear in illustrative embodiments, there will be immediately obvious to those skilled in the art many modifications of structure, arrangement, proportions, the elements, materials, and components used in the practice of the invention, and otherwise, which are particularly adapted for specific environments and operative requirements without departing from those principles. For example, in place of the ratchet apparatus disclosed and discussed, it is obvious that any appropriate apparatus could be used, such as one way clutch apparatus. The appended claims are intended to cover and embrace any and all such modifications, within the limits only of the true spirit and scope of the invention. This specification and the appended claims have been prepared in accordance with the applicable patent laws and the rules promulgated under the authority thereof.

What is claimed is:

l. The method for removing a cast, comprising the steps of:

placing a wire along a limb;

making a loop in the wire intermediate the ends of the wire;

embedding the wire under the cast with the loop extending outwardly of the cast and with the ends of the wire secured within the cast;

cutting the wire into two portions by cutting the loop;

securing a first portion of the wire onto a spool; and

imparting rotary motion to the spool to draw the wire through the cast to fracture the cast.

2. The method of claim 1 which includes the step of placing the loop in the wire at a bend in the cast.

3. The method of claim 2 which includes the step of placing a pair of wires in parallel relation to each other along a limb.

4. The method of claim 3 which includes the steps of placing one wire of the pair on the anterior portion of the limb and of placing the other wire ofthe pair on the posterior portion of the limb.

l =l =l 

1. The method for removing a cast, comprising the steps of: placing a wire along a limb; making a loop in the wire intermediate the ends of the wire; embedding the wire under the cast with the loop extending outwardly of the cast and with the ends of the wire secured within the cast; cutting the wire into two portions by cutting the loop; securing a first portion of the wire onto a spool; and imparting rotary motion to the spool to draw the wire through the cast to fracture the cast.
 2. The method of claim 1 which includes the step of placing the loop in the wire at a bend in the cast.
 3. The method of claim 2 which includes the step of placing a pair of wires in parallel relation to each other along a limb.
 4. The method of claim 3 which includes the steps of placing one wire of the pair on the anterior portion of the limb and of placing the other wire of the pair on the posterior portion of the limb. 